Kyriakides: 'Our goal now, medicines for all'

"I have always envisioned a European Health Union, where the European Union would be intimately connected to every citizen regarding health matters. This vision, amidst an unprecedented public health crisis like the pandemic, which has tragically claimed the lives of over 20 million people globally according to WHO estimates, has propelled us towards its realization," states Stella Kyriakides, the European Commissioner for Health, in an interview with "K." She candidly shares details of the ambitious plan to implement pharmaceutical reform, aiming for equitable access to medicines for all. The timing of its adoption, she emphasizes, rests with the European Parliament and the European Council. Reflecting on her meeting with G7 Health, she highlights, "Recently, we established the first-ever Health Task Force with the United States. In today's interconnected world, we cannot address major crises or tackle health issues such as cancer without collaboration. Diseases do not recognize borders." When questioned about her thoughts on resigning during this tumultuous period or the possibility of reappointment, she provides her response.

- The health sector has been overlooked by many countries for years, and to be honest, it hasn't been a top priority for the EU either. Can we assume that the pandemic has played a catalytic role in reshaping our approach to the health sector?

- I often say that great crises bring opportunities for significant change. I have always envisioned a European Health Union where the European Union would be more connected to every citizen regarding health matters. This vision has been fueled by an unparalleled public health crisis, a pandemic, which has had devastating consequences. The WHO estimates that over 20 million people worldwide have lost their lives due to the pandemic. However, we have energetically progressed toward realizing this vision. When I took over the health portfolio, the total budget was around €418 million until 2027. Today, we have established the EU4Health program with a budget of €5.3 billion. I would like to emphasize the immense importance of President von der Leyen and my dear friend Vice-President Margaritis Schinas, as they shared the same vision from the beginning. The Vice-President's support has been invaluable to me. So, yes, the pandemic has played a catalytic role in transforming how we address health issues in the EU, but it wasn't the sole factor. We recognized the "opportunity" within this unprecedented crisis, and we took bold steps to deliver.

- Since you assumed your position, you were immediately confronted with this immense crisis and its repercussions. Was there a moment when you felt isolated in all of this?

- I believe that everyone has experienced moments of isolation, and I am no exception. However, the sense of responsibility was intense. To me, individuals are never mere statistics. Their well-being and needs weighed heavily on my mind. I considered the doctors and nurses who battled tirelessly in overcrowded hospitals and medical centers, the fears harbored by all, particularly the vulnerable groups among us, the consequences of lockdowns, unemployment, loneliness, and the fear of an unknown disease. We were navigating uncharted territory, unaware of how COVID-19 would unfold. No one could guarantee the development of effective vaccines to shield our societies. What we currently take for granted was not certain back then. We often tend to forget, but it's essential to remember our starting point and acknowledge the progress we have collectively achieved. For me, this collectivity was key—our ability to unite at the European level. We strived to ensure that no one would be left behind and that all citizens would have equitable access to safe vaccines simultaneously. This has been an unprecedented feat, both globally and within the European context.

- Have you considered the possibility of resigning?

- The answer is simple, no. I didn't learn to give up in the face of adversity.

- Looking back, how do you assess the vaccine policy and its management? It seemed to have caused significant divisions within societies across Member States...

- I am absolutely confident that we made the right decision. We had to invest in research, and manufacturing while simultaneously ensuring equal access for all citizens. Furthermore, it demonstrated the strength of the EU when united. Regarding the societal divisions, I must acknowledge that misinformation surrounding the coronavirus had reached alarming levels. That's why we consistently emphasized the importance of relying on credible scientific sources for information. Citizens were encouraged to follow the guidance provided by their national health authorities, as well as the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO). While I understand that some individuals may have been hesitant in the face of an entirely unknown situation, it is crucial to note that this mass vaccination campaign represents the largest in history.

- What does the declaration of the end of the pandemic truly signify? Does it mean that we have returned to normal and the virus is now a thing of the past?

- After three years, COVID-19 is no longer classified as a global health emergency. This is a significant accomplishment resulting from our collective actions and effective pandemic management, highlighting the tremendous global efforts and sacrifices made by our citizens. However, COVID-19 still poses a health threat that persists. We must remain cautious, stay vigilant, and continue monitoring for new variants.

-You have noted how much the EU has increased the health budget compared to the past. Does that mean that it can prevent a repeat of what we experienced with covid or can a focus on health help to better deal with such a health crisis in the future?

-It is precisely for this reason that we created, a year ago, the Health Preparedness and Response Authority known as (HERA), which will enable anticipation and preparation against threats and potential health crises. So that in the event of an emergency, HERA will be able to act immediately. HERA is also a key pillar of the European Health Union.

Our Mental Health Strategy should be announced in June

-The pandemic has, of course, highlighted the importance of mental health. Will there be any initiative on the part of the EU or is it still a footnote?

-Mental health is today - more than ever - a huge challenge for public health. Our citizens are recovering from an unprecedented pandemic with anxiety, fear, unprecedented measures, the insecurity of the energy crisis and the brutal invasion of Ukraine. In the EU, even before the pandemic, around one in six citizens (around 84 million people) were already experiencing mental health problems, and today in several Member States the proportion of young people reporting symptoms of depression appears to have more than doubled. Our aim is to fight prejudice and stigma. The need to act as a whole is urgent. That is why in June we will present our comprehensive approach to mental health. There will be a strong focus on vulnerable groups - including children, young people and the elderly. We will provide financial support but also expertise to Member States and stakeholders.

Another pillar of the European Health Union is being implemented

- The reform of the single market for medicines has recently been announced. What are the main changes?

- In three words, 'Medicines for all'. This is what the new pharmaceutical reform is all about, a historic reform after 20 years. Equal access to medicines for all European citizens - regardless of their country of residence. Whether they are innovative, for rare diseases, for cancer, or for a simple headache. In a European Health Union, we cannot have first- and second-class citizens when it comes to access to medicines. This is not acceptable. Pharmaceutical Reform comes precisely to correct this inequality so that no one is left behind.

- When can we expect its implementation?

- That will depend on the determination of the European Parliament and the Council to adopt it.

- How will you, however, deal with the reactions of pharmaceutical companies who feel that their interests and profits are threatened?

- It is important that the European pharmaceutical industry remains at the forefront of innovation. That is why we are providing strong incentives for innovation and less burden on companies and regulators. The incentives that will be given will provide access to new medicines for around 70 million more citizens than today. Innovation must reach patients - to be of value. At the same time, we will reduce licensing procedures and timelines to ensure that medicines reach patients faster, from around 400 days today to 180. All of this is important for the industry, as we expect that it could deliver savings of between €500 million and €1 billion over the next 15 years.

- Are you concerned that this ambitious project may be drastically changed in the end because of big interests?

- I certainly would not want it to be changed or delayed, because that is what the current needs of our citizens demand. We have worked intensively and ambitiously with the interests of European citizens at heart. I am confident that this will be the compass for the other European institutions involved to make this urgent need a reality.

The G7 Health and diseases that know no borders

- What did you take away from your meeting in Nagasaki with the G7 Health?

- I keep the important relationship of trust that has developed between the G7 health ministers, I keep our common goals of strengthening the global health architecture, our common approach and preparedness for crisis response. We have already started a discussion on Long Covid for sharing global expertise.  We have, just recently, created the first Task Force on Health with the US. In the world we live in today, we cannot tackle major crises, or major health issues such as cancer, without cooperation. Diseases know no borders. And we must respond in a different way while supporting the most vulnerable countries.

- This turbulent term of office ends in a year. Is there anything else you would like to accomplish before it ends?

- There are too many issues that are still important to push forward. The European Cancer Plan is in its fourth year of implementation, this year alone we have 30 proposals, and it has already delivered results for Member States. We want to move forward with e-health so that every citizen can have his or her own personal electronic health record, the implementation of the European action plan against antimicrobial resistance under the 'One Health' approach and to achieve a global agreement on antimicrobials. The implementation of the Farm to Plate Strategy is particularly important and we are moving ahead with its implementation.

- Is the possibility of reappointment to the Commission something you are considering or interested in?

- I still have a lot of work ahead of me. Every day, new challenges. I want to be as effective as I can be in what I serve today. We have all seen that life is full of twists and turns and unexpected events. The one thing I can tell you with certainty is that from whatever position I am in, I will always give as much as I can to the community. That does not change.

[This interview first appeared in Kathimerini's printed Sunday edition and was translated from its Greek original]